Individual
GAE WON KWON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1901 CALLE DE NINOS, LAS CRUCES, NM 88005-3293
(575) 526-5522
Mailing address
13403 NEWCASTLE COMMONS DR APT 301, NEWCASTLE, WA 98059-3220
(949) 355-3676
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DS040063
PA
1223P0221X
Pediatric Dentistry
DD5471
NM
1223P0221X
Pediatric Dentistry
Primary
DE.61294850
WA
Other
Enumeration date
08/03/2014
Last updated
11/10/2022
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